In the past many urological procedures were performed percutaneously, which created many problems and added extra steps and side effects to the procedure. For example, percutaneous procedures were performed on the kidney, such as percutaneous nephrolithotomy for staghorn or partial staghorn renal calculi. A significant amount of irrigant is often used during these procedures, which may wash particulate down the ureter. The particulate matter within the irrigant has been known to cause blockage within the urinary tract when it is allowed to flow through this flow path during these types of procedures. Because the ureter is formed with a relatively small cross-sectional area, it is a known problem that particulate matter from the kidney can become lodged within the ureter or the junctions between the kidney and the ureter, and between the ureter, the bladder, and the ureteral-vesico junction (UVJ). This type of blockage can have harmful effects on the patient, such as discomfort, hyrdonephrosis, and infection, and must be treated to allow the urinary system to function properly.
Therefore, it is common to employ a balloon at the ureteropelvic junction (UPJ). The balloon occludes the urinary tract downstream of the kidney and avoids the problem of particulate matter being entrained within the irrigant and becoming lodged within the urinary tract. While this step is often successful in preventing the blockage of the downstream urinary tract, it has been shown to increase renal pressure, which can result in post operative complications.
To avoid these problems, and the additional general problems that come with any percutaneous procedure, the use of flexible, kink-resistant introducer sheaths have been employed to perform urological procedures. These sheaths may be introduced into the urinary tract through the urethral meatus and extend through the urethra, the bladder, and the ureter to reach the UPJ in close proximity to the kidney. The sheath allows the urological procedure to be performed on the kidney or an associated organ by transporting the tools through the sheath to the area of concern. Additionally, the use of the sheath allows for the free flow and drainage of irrigant that is created during the procedure.
Currently, the access sheaths that are used in conjunction with urological procedures do not include any device or mechanism for containing or retaining the irrigant that exits the access sheath. Often this irrigant is spilled on the floor of the medical facility and is disposed of through the drainage system of the facility. The loss of particulate matter that may be entrained within the irrigant becomes a lost opportunity for examination and testing. The particulate matter could be beneficially analyzed after the procedure through procedures that are known in the art, to aid in the diagnosis of the patient or for broader testing and experimentation. What is needed is a way to collect the particulate matter created during percutaneous procedures.